缪仲淳治于润父夫人,妊九月,患伤寒阳明症,头痛壮热,渴甚,舌上黑苔有刺,势甚危。缪投竹叶石膏
汤,索白药子(医马病者。)不得,即以井底泥涂脐上,干则易之。一日夜尽石膏十五两五钱。病瘳产一女,母子毋恙。
治妊娠伤寒,护胎为要,否则堕胎多死。以白药子为细末,鸡子清调摊绵纸上如碗大,自脐贴至脐下胎
存生处,干即以湿水润之,临产者慎勿忘此。
冯楚瞻治一孕妇,劳役受寒,忽四肢厥冷,喘急大作,额汗如雨,六脉沉细欲绝。令以人参五钱,桂、附
共三钱煎服。病家曰∶已孕三四月,服桂、附保勿堕乎?曰∶此时重母不重子,未有母亡而子活者。服下少顷,
即吐出清水,药入肠胃,其声 直达而下,作嗳数声,喘减汗收,脉渐起。乃平和调理,以渐而安,十月足,
生一子。
张路玉治一妇人,素禀气虚多痰,怀妊三月,因腊月举丧受寒,遂恶寒呕逆清血,(血字疑水字之误。)腹痛下坠。
脉得弦细如丝,按之欲绝。与生料干姜人参半夏丸,二服不应。更与附子理中加苓、半、肉桂,调理而康。大
抵怀孕母气多火,得连则安,多寒得桂、附则安,多痰得苓、半则安,务在调其偏胜,适其寒温。未有母气逆
而胎得安,亦未有母气安而胎反堕者。(较冯说自然。)所以《金匮》有怀妊六七月,胎胀,腹痛恶寒,少腹如扇,
用附子汤温其脏者。然认症不果,不得妄行是法。一有差误,祸不旋踵,非比芩、连之误,犹可引延时日也。
Miao Zhongchun treated the wife of Yu Runfu, who was nine months pregnant and suffering from Yangming syndrome (a stage in Shanghan Lun where heat is abundant) due to cold damage. She presented with headache, high fever, extreme thirst, and a black tongue coating with prickles, indicating a critical condition. Miao administered Zhuyeshigu Tang (Bamboo Leaf and Gypsum Decoction). He requested Baiyaizi (Aristolochia debilis root, used for treating horse diseases), but it was unavailable, so he applied mud from the bottom of a well to her umbilicus, replacing it when dry. Within one day and night, she consumed fifteen taels and five qian of gypsum. The illness resolved, and she delivered a healthy daughter; both mother and child were safe.
When treating cold damage during pregnancy, protecting the fetus is paramount; otherwise, miscarriage and death are common. Pulverize Baiyaizi, mix with egg white, spread on cotton paper to the size of a bowl, and apply from the umbilicus down to the area below where the fetus is implanted. If it dries, moisten it with water. Do not forget this method near delivery.
Feng Chuzhan treated a pregnant woman who, after overwork and exposure to cold, suddenly developed cold limbs, severe asthma and urgency, profuse sweating on the forehead like rain, and deep, fine pulses nearly imperceptible. He prescribed Ren Shen (Ginseng Root) 5 qian, combined with Gui Zhi (Cinnamon Twig) and Fu Zi (Aconite Lateralis Preparata) totaling 3 qian, decocted and administered. The family asked, "She is three or four months pregnant; will taking Cinnamon Twig and Aconite cause a miscarriage?" Feng replied, "At this time, saving the mother takes precedence over the fetus; there is no case where the mother dies and the fetus survives." After a short while, she vomited clear fluid, the medicine entered the stomach and intestines, sound traveled downward, she belched several times, her breathing eased, sweating stopped, and her pulse gradually recovered. Subsequent mild regulation led to gradual stability. She carried to term and gave birth to a son.
Zhang Luyu treated a woman constitutionally deficient in Qi and prone to phlegm. At three months pregnant, she caught cold while attending a funeral in the twelfth lunar month, resulting in aversion to cold, vomiting of clear fluid (the character 'blood' is likely an error for 'water'), abdominal pain, and a sensation of bearing down. Her pulse was wiry and fine as a thread, barely perceptible upon pressure. He administered Shengliao Ganjiang Renshen Banxia Wan (Raw Material Dried Ginger, Ginseng, and Pinellia Pill). After two doses, there was no response. He then switched to Fuzi Lizhong Jia Ling Ban Rougui Tang (Aconite and Poria Decoction with Added Poria, Pinellia, and Cinnamon Bark), which cured her through regulation. Generally, if the maternal constitution tends toward heat, Huang Lian (Coptis Rhizome) brings peace; if toward cold, Gui Zhi and Fu Zi bring peace; if toward phlegm, Fu Ling (Poria) and Ban Xia (Pinellia Tuber) bring peace. The key is to adjust the excess and ensure appropriate warmth or cooling. There is no instance where fetal safety exists amidst maternal Qi rebellion, nor is there any case where maternal Qi is stable yet the fetus miscarries. (This view is more natural than Feng's.) Therefore, *Jingui Yaolue* states that in the sixth or seventh month of pregnancy, if there is fetal distension, abdominal pain, aversion to cold, and a sensation of cold in the lower abdomen as if fanned by a wind, Fuzi Tang (Aconite Decoction) should be used to warm the viscera. However, if the syndrome differentiation is not accurate, this method must not be used recklessly. Any error leads to immediate disaster, unlike errors with Huang Qin (Scutellaria Root) or Huang Lian, which might only delay the outcome.